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Livedo racemosa

Livedo racemosa (LR) is a skin condition with persistent red or violet discoloration, characterized by a broken, branched, discontinuous and irregular pattern lesions.

It is a pathological skin condition characterized by a violaceous, net-like pattern with irregular, broken, and non-uniform mottling.

It is a fragmented reticular pattern of skin discoloration caused by a pathological disruption of cutaneous blood flow and is distinct from the continuous reticular pattern of livedo reticularis.

Unlike livedo reticularis, which is often physiological and can be induced by cold, livedo racemosa persists regardless of temperature changes and is typically associated with underlying systemic or vascular abnormalities.

It can be a manifestation of various conditions, including thrombotic/hypercoagulable disorders, embolic events (cholesterol emboli or gas bubbles in decompression sickness), and vasculitides as with  Sneddon syndrome, systemic lupus erythematosus.

LR is often seen in association with neurological diseases, where it may indicate an underlying inflammatory or systemic disorder.

The presence of livedo racemosa warrants an evaluation for potential underlying causes, including hypercoagulable states, autoimmune diseases, and embolic sources.
Diagnostic workup may include skin biopsy, laboratory tests for coagulation disorders, and imaging studies to identify any associated systemic involvement.

Livedo racemosa can be restricted to the limbs or a diffuse process.

Livedo racemosa is usually the first sign of a systemic vascular disorder.

 

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